Immunosuppression on Kidney Transplantation Among Identical Twins – Yes or Not?
Krzysztof Dziewanowski, Radosław Drozd, Anna Chojnowska, Marek Myślak, Jerzy Sieńko, Marek Ostrowski
Department of Nephrology, Regional Hospital, Szczecin, Poland
Med Sci Case Rep 2016; 3:97-99
Available online: 2016-11-25
Immunosuppression treatment after a kidney transplant between twins is still controversial. There are arguments for and against it reported in the literature.
CASE REPORT: A case of a successful kidney transplantation among two homozygous twins is presented here. Prior to the familial kidney transplantation from the identical twin, the patient underwent peritoneal dialysis and hemodialysis, as well as a cadaveric kidney transplant from an unrelated donor. In our patient, vascular accessibility was poor and the second, familial transplantation was performed urgently. The transplanted kidney function proved excellent, however, the issue of the best immunosuppressant to be selected required careful consideration.
CONCLUSIONS: The optimal treatment in a similar clinical situation requires individual consideration as to the degree of genetic and immunologic concordance, concomitant disease, as well as additional factors influencing future outcomes of the transplant, with decisions on the exact immunosuppressive regimen also related to the function of the transplanted kidney.
Keywords: Immunosuppression, Kidney Transplantation, Renal Insufficiency, Chronic, Twins, Monozygotic